Healthcare Provider Details

I. General information

NPI: 1659580322
Provider Name (Legal Business Name): PHYSICAL REHABILITATION & HAND CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S ANDREASEN DR STE C/D
ESCONDIDO CA
92029-1917
US

IV. Provider business mailing address

600 S ANDREASEN DR STE C/D
ESCONDIDO CA
92029-1917
US

V. Phone/Fax

Practice location:
  • Phone: 760-591-7750
  • Fax: 760-294-9813
Mailing address:
  • Phone: 760-591-7750
  • Fax: 760-294-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID C. BOUTELLE
Title or Position: PRESIDENT OWNER
Credential: M.P.T.
Phone: 760-591-7750